Comparative evaluation of knowledge levels and attitudes regarding periodontal health and periodontal disease among internal medicine physicians and dentists in Turkey: a cross-sectional survey study.

backgroundPeriodontal diseases are closely related to various systemic conditions including diabetes mellitus (DM), cardiovascular diseases, adverse pregnancy outcomes, and rheumatoid arthritis (RA). Internal medicine physicians frequently encounter patients with these systemic conditions and are in a strategic position to facilitate early diagnosis and referral for periodontal problems. Despite international evidence suggesting significant knowledge gaps among medical practitioners regarding periodontal health, limited data are available from Turkey. The aim of this study was to evaluate the knowledge levels and attitudes of internal medicine specialists and residents regarding periodontal health and periodontal disease, and their relationship with systemic conditions, in comparison with dentists.

methodsThis cross-sectional descriptive survey study was conducted between April 2021 and December 2021 in Turkey. A content-validated, self-administered online questionnaire consisting of 7 sociodemographic questions and 29 questions related to periodontal health and periodontal disease knowledge and attitudes was distributed to internal medicine specialists/residents (IMS group, n = 107) and dentists (control group, n = 133) via social media platforms. Internal consistency was assessed using Cronbach's alpha (α = 0.829). Normality of continuous variables was assessed using the Shapiro-Wilk test. Data were analyzed using chi-square tests, Kruskal-Wallis tests, and Mann-Whitney U tests, with statistical significance set at p < 0.05. Bonferroni correction was applied for multiple comparisons. Multiple linear and logistic regression models were used to adjust for potential confounders.

resultsA total of 240 participants met the inclusion criteria. Internal medicine specialists/residents demonstrated significantly lower knowledge levels compared to dentists across most periodontal knowledge domains (p < 0.05). Only 65.4% of the IMS group correctly defined periodontitis compared to 98.5% of dentists (p < 0.001). Knowledge gaps were particularly prominent regarding the relationship between periodontal disease and pregnancy complications (46.7% vs. 91%, p < 0.001), the effect of smoking on periodontal tissues (59.8% vs. 97.7%, p < 0.001), and the role of radiographic examination in periodontal diagnosis (37.4% vs. 88.8%, p < 0.001). After Bonferroni correction, 14 of 22 comparisons remained statistically significant. Notably, both groups showed high and comparable knowledge regarding the recognition of diabetes as a risk factor for periodontitis (IMS: 93.5% vs. dentists: 92.5%). Subgroup analysis revealed that specialists scored significantly higher than residents across all knowledge domains (total score: 16.94 ± 2.90 vs. 14.38 ± 3.73, p < 0.001). Multivariate analysis confirmed that group differences remained significant after adjusting for age, sex, marital status, and years since graduation (adjusted B = 4.65, p < 0.001). Self-assessment scores for periodontal knowledge significantly increased after completing the survey in the IMS group (4.02 to 5.34, p < 0.001).

conclusionsThe findings of this study suggest that internal medicine specialists and residents in Turkey may have lower knowledge levels regarding periodontal health and periodontal disease, and the periodontal-systemic health relationship compared to dentists. Specialists demonstrated significantly higher knowledge than residents across all domains. While these results should be interpreted within the context of the study's methodological limitations, they point to a potential need for integration of oral health education into medical curricula and enhanced interprofessional collaboration between medicine and dentistry. Further research using representative sampling strategies and longitudinal designs is warranted to confirm these findings.